Behrman Alison, Dahl Linda D, Abramson Allan L, Schutte Harm K
Department of Otolaryngology, Center for the Voice, The New York Eye and Ear Infirmary, New York NY 10003, USA.
J Voice. 2003 Sep;17(3):403-10. doi: 10.1067/s0892-1997(03)00018-3.
Two vocal tract postures commonly identified as hallmarks of nonorganic dysphonia are anterior-posterior and medial compression of the supraglottis. However, insufficient data exist to support their diagnostic utility. The purpose of this study was to compare these two postures in patients with nonorganic dysphonia and normal controls using interval data derived from quantitative measures of videostroboscopic images obtained with an oral endoscope. Retrospectively, 40 patients with nonorganic dysphonia and 40 normal controls were selected. Relative anterior-posterior compression (LO(AP)) was calculated as the laryngeal outlet (LO) (the view of the true vocal folds during phonation) normalized to the anterior-posterior dimension in pixels. Relative ventricular fold medial compression (LO(w)) was calculated as the laryngeal outlet normalized to the medial dimension in pixels. Results were as follows: (1) LO(AP) was significantly greater for the dysphonic group, (2) the range of LO(AP) values between the two groups overlapped considerably, (3) no significant difference was found between groups for LO(w), (4) the correlation between LO(AP) and LO(w) within each subject yielded r values of 0.71 and 0.67 for the nonorganic dysphonia and normal control groups, respectively. It is concluded that medial compression of the ventricular folds can be a normal laryngeal posture, and that although anterior-posterior compression is present in greater degree in dysphonics, it is sufficiently common in normals to question its utility as a diagnostic sign of phonatory dysfunction.
两种通常被视为非器质性发声障碍标志的声道姿势是声门上区的前后压缩和内侧压缩。然而，支持其诊断效用的数据不足。本研究的目的是使用从口腔内窥镜获得的频闪视频图像定量测量得出的区间数据，比较非器质性发声障碍患者和正常对照者的这两种姿势。回顾性地选取了40例非器质性发声障碍患者和40名正常对照者。相对前后压缩（LO(AP)）计算为喉口（LO）（发声时真声带的视图）除以像素的前后尺寸。相对室带内侧压缩（LO(w)）计算为喉口除以像素的内侧尺寸。结果如下：（1）发声障碍组的LO(AP)显著更大，（2）两组之间LO(AP)值的范围有相当大的重叠，（3）两组之间在LO(w)方面未发现显著差异，（4）在每个受试者中，非器质性发声障碍组和正常对照组的LO(AP)与LO(w)之间的相关性r值分别为0.71和0.67。得出的结论是，室带的内侧压缩可以是一种正常的喉部姿势，并且虽然发声障碍者中前后压缩程度更大，但在正常人中也足够常见，从而质疑其作为发声功能障碍诊断标志的效用。
